Short People at Higher Risk of Heart Disease

It’s been established for decades that shorter stature is associated with a higher risk of heart disease, but a new study in the New England Journal of Medicine may provide greater insight into the underlying mechanisms that explain the relationship between height and heart disease.

“We have shown that the association between shorter height and higher risk of coronary heart disease is a primary relationship and is not due to confounding factors, such as nutrition or poor socioeconomic conditions,” says Nilesh J. Samani, MD, British Heart Foundation professor of cardiology at the University of Leicester in England.
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Samani and his colleagues analyzed genetic data from 200,00 participants with or without coronary heart disease and examined whether 180 genetic variants that affect height were also associated with coronary heart disease.

They found that each 2.5-inch change in height affects an individual’s risk of coronary heart disease by 13.5%. For instance, a person who is 5 feet tall has a 32% higher risk of coronary heart disease than a person who is 5 feet 6 inches.

“The beauty about DNA is that it cannot be modified by one’s lifestyle or socioeconomic conditions,” Samani says. “Therefore, if shorter height is directly connected with increased risk of coronary heart disease, one would expect that these variants would also be associated with coronary heart disease and this is precisely what we found.”

The team also investigated whether other known risk factors, such as cholesterol, high blood pressure, and diabetes, could explain the link between shorter height and coronary heart disease risk. They only found an association with cholesterol and fat levels that could explain less than a third of the relationship between shorter height and coronary heart disease.

The authors believe that biological processes that determine height and coronary heart disease development are responsible for the remaining two thirds of the association. One hypothesis they have is that shorter people may have proportionally smaller coronary arteries, so that even the same amount of plaque buildup might have a greater adverse effect on them than their taller counterparts.

“While we know about many lifestyle factors such as smoking that affect risk of coronary heart disease, our findings underscore the fact that the causes of this common disease are very complex and other things that we understand much more poorly have a significant impact,” Samani says.

The team believes that further exploration of these genes and a understanding of the biological mechanisms underlying this relationship may suggest new ways to reduce the risk of heart and circulatory disease.

—Colleen Mullarkey

Reference

Nelson CP, Hamby SE, Saleheen D, Hopewell JC, Zeng L, Assimes TL, et al. Genetically determined height and coronary artery disease. New Engl J Med. 8 April 2015. [Epub ahead of print].